Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $128.82 / $204.17	Facility		$85.11	$128.82	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $95.50 / $251.19	Professional		$58.88	$95.50	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $158.49 / $269.15	Professional		$100.00	$158.49	$269.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $190.55	Professional		$120.23	$158.49	$190.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $125.89 / $186.21	Facility		$70.79	$125.89	$186.21
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $123.03 / $213.80	Professional		$70.79	$123.03	$213.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $138.04 / $162.18	Facility		$104.71	$138.04	$162.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $114.82 / $169.82	Facility		$70.79	$114.82	$169.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $144.54 / $223.87	Professional		$79.43	$144.54	$223.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $186.21 / $223.87	Professional		$128.82	$186.21	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $128.82 / $218.78	Professional		$81.28	$128.82	$218.78